磁共振显微线圈在早期类风湿性关节炎诊断中的价值

目的 探讨磁共振（Magnetic Resonance Imaging,MRI）显微线圈在早期类风湿性关节炎（Rheumatoid Ar-thritis,RA）诊断中的价值.方法 对早期RA患者48例使用显微线圈Micro-23行近端指间关节MRI检查,观察早期RA近端指间关节的软骨损伤在MRI上的表现,对比X线检查及MRI检查对早期RA的诊断价值,并分析抗环瓜氨酸肽（CCP）抗体及类风湿因子（RF）与MRI提示的关节软骨损伤程度的相关性.结果 本组48例患者中,X线平片阳性8例,阳性率为16.7％,而MRI均有不同程度阳性表现,其阳性率为100％.在所有病例近端指间关节的软骨损伤程度MRI分级中,不同MRI软骨损伤分级,血清抗CCP抗体水平、RF水平均有显著差异,且差异有统计学意义（P＜0.001）；损伤程度越高,抗CCP抗体水平和RF水平值越大.结论 MRI显微线圈较常规X线对早期RA诊断率高,可以观察类风湿关节炎患者软骨损伤程度,更好地反映疾病的进展及预后,抗CCP抗体和RF均与MRI提示的关节软骨损伤程度具有相关性,提示抗CCP抗体及RF可以用来评价疾病活动度和预测软骨侵蚀程度.

The value of MRI micro coil in diagnosis of early Rheumatoid arthritis

Objective To evaluate the value of MRI micro coil in diagnosis of Rheumatoid arthritis. Methods collec- ting the early RA patients 48 cases. To observe the performance of proximal interphalangeal joint cartilage, subchondral bone erosion, peripheral synovial pannus infringement and joint effusion in MRI by using micro coil,Contrast X-ray and the value of MRI in the diagnosis of early RA. Meanwhile, to explore the correlation between anti-cyclic ciyellinated peptide antibody（anti-CCP）and rheumatoid factor（RF）with cartilage injuries in patients with early rheumatoid arthri- tis. Results in 48 cases of patients, 8 cases of X-ray plain film positie, positive rate was 16.7 %, and magnetic resonance imaging （MRI） positive rate was 100 %. In all cases of proximal interphalangeal joint cartilage damage degree MRI clas- sification of different MRI cartilage injury classification,anti-CCP antibody levels,RF level have significant difference, and the difference was statistically significant （P 〈 0. 001） ;Damage degree is higher, the value of the anti-CCP anti- body level and RF level is larger. Conclusion early RA diagnosis rate of MRI micro coil is higher than conventional X- ray, observed in patients with RA cartilage damage degree, better reflect the progress and prognosis of illness, anti-CCP antibody and RF were associated with articular cartilage damage degree,anti-CCP antibody and RF can be used to eval- uate disease activity and predict cartilage erosion degree.